Michele A Mittelbronn, M.D.

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

22838 Issued in SC

Practice address

999 Lake Hunter Cir
Suite B
Mt Pleasant, SC 29464-5427

Phone

(843) 881-2265

Fax

(843) 881-2789

NPI assigned

May 16, 2006

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Coastal Dermatology, LLC

  • Dermatology Physician
  • Mount Pleasant, SC
  • NPI 1164690822
  NPD
• Mt Pleasant Dermatology

  • Dermatology Physician
  • Mt. Pleasant, SC
  • NPI 1821048828
  NPD (past)
• Triple Crown of Mt Pleasant LLC

  • Physical Therapy Clinic/Center
  • Mt Pleasant, SC
  • NPI 1306288261
  NPD (past)
• Frederick Health Hospital Inc

  • General Acute Care Hospital
  • Frederick, MD
  • NPI 1538165527
  NPD (past)
• Southeastern Dermatology Consultants, PC

  • Dermatology Physician
  • Knoxville, TN
  • NPI 1427109446
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1147737600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1316649600000",
    "number": "1790736312",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "999 LAKE HUNTER CIR",
            "address_2": "SUITE B",
            "city": "MT PLEASANT",
            "state": "SC",
            "postal_code": "294645427",
            "telephone_number": "843-881-2265",
            "fax_number": "843-881-2789"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "999 LAKE HUNTER CIR",
            "address_2": "SUITE B",
            "city": "MT PLEASANT",
            "state": "SC",
            "postal_code": "294645427",
            "telephone_number": "843-881-2265",
            "fax_number": "843-881-2789"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MITTELBRONN",
        "first_name": "MICHELE",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-16",
        "last_updated": "2011-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "SC",
            "license": "22838",
            "primary": true
        },
        {
            "code": "207ND0900X",
            "taxonomy_group": "",
            "desc": "Dermatology, Dermatopathology",
            "state": "SC",
            "license": "22838",
            "primary": false
        },
        {
            "code": "207NP0225X",
            "taxonomy_group": "",
            "desc": "Dermatology, Pediatric Dermatology",
            "state": "SC",
            "license": "22838",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX ID",
            "identifier": "200070804",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Thomas Joseph Mirabile, OD
• Melissa Mitchell-Blitch, LPC, CACII
• Ashley Nicole Mitchell, PHARM D.
• Elizabeth Nicole Mitchell, PHARMD
• Michael C Mithoefer, MD
• Derek Mobley
• Jessica Mobley
• Palmira Teresa Modica, PHARMD
• Bethany Kristen Moebs, DPT, PT
• Harley Moit, D.O.

• Dermatology Physician in Mt Pleasant, SC
• Providers in Mt Pleasant, SC by specialty
• Dermatology Physician in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.